Provider Demographics
NPI:1154417020
Name:PALMEN, MICHAEL A (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:PALMEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7415
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55903-7415
Mailing Address - Country:US
Mailing Address - Phone:507-269-6992
Mailing Address - Fax:507-282-1735
Practice Address - Street 1:20 2ND AVE SW
Practice Address - Street 2:STE M114
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55902
Practice Address - Country:US
Practice Address - Phone:507-269-6992
Practice Address - Fax:507-282-1735
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN264502084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
D81950Medicare UPIN